Spectator Magazine June 2018

Ankle Arthritis
By Dr. Clive C. Woods
Ankle arthritis can occur for numerous reasons. Majority of patients with ankle arthritis have sustained prior trauma, have an inflammatory
arthritis, or history of infection as a cause. Multiple treatment options are available for arthritis of the ankle. Determining the
ideal option of treatment requires taking into account level of pain, patient factors, alignment of the extremity, and patient expectations.
The goal of bracing is to minimize motion across the ankle joint Support above and below the ankle joint is a necessity.
Patients with arthritic ankles often discover that high top boots and shoes are more comfortable. When considering bracing there are
many options ranging from over-the-counter lace-up type athletic ankle braces, to a custom-molded ankle foot orthoses (AFO). In
the more severe cases, an Arizona brace (lace-up leather brace) is often a good choice because it provides good support of the
ankle joint while still fitting in most types of shoes. Quite often however, the shoe needs to be a bigger size to accommodate the
brace. Corticosteroids may have a role in the treatment of arthritic symptoms, but are not without risk. They can cause damage to
the soft tissues around the ankle with frequent use. The role of viscosupplementation (i.e. Synvisc, Supartz) injections in the ankle
joint remains controversial. The effectiveness of injections can decrease overtime.
The decision for surgical intervention occurs when nonoperative management does not alleviate pain for a patient to continue with
activities of daily living. Depending on the severity of the condition ankle arthroscopy can help eliminate bone spurs, scar tissue from
trauma, and inflamed tissue within the ankle. The gold standard for ankle arthritis is an ankle fusion. It is an excellent procedure to
alleviate pain at the ankle joint. Ankle fusion is not entirely without its problems. After an ankle fusion, approximately 50% of patients
demonstrate arthritis in nearby joints within 7-10 years. Since the 1990s, interest in total ankle replacement has re-emerged with
improved designs. Ankle replacements eliminate the problem of arthritis in other joints, which occur in ankle fusion. The long- term
outcomes of ankle replacement are continually being monitored.
Dr. Woods completed his foot & ankle fellowship at the esteemed Florida Orthopaedic Institute in Tampa Bay, FL and received
his medical degree from Meharry Medical College in Nashville, TN where he was a member of Alpha Omega Alpha Medical
Honor Society.
While completing his internship and residency programs at University of Miami’s Jackson Health System, Dr. Woods provided
world class treatment for a variety of South Florida patients – including University of Miami Hurricanes athletes.
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